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Quality Account 2018-19 QUALITY ACCOUNT 2018-19 Providing outstanding care that we and our families would want to use 2 | Hounslow and Richmond Community Healthcare NHS Trust Contents About our Quality Account 4 About HRCH 5 Chief Executive and Chairman’s Statement 8 Part 1 - How we did - Our priorities for improvement in 2018/19 12 Patient safety 12 Clinical effectiveness 14 Patient experience 16 Other areas of quality improvement in 2018/19 18 Part 2 - Review of services 34 Part 3 - Our priorities for improvement for 2019/20 Quality Priorities 2019/20 44 Monitoring progress throughout the coming year 46 Statements from Healthwatch, Overview & Scrutiny Committees and Commissioners 47 Quality Account 2018/19 | 3 About our Quality Account Welcome to the Hounslow and Richmond Community Healthcare NHS Trust (HRCH) Quality Account for 2018/19. HRCH is a community healthcare provider, providing healthcare to people in their homes and the local community. The Quality Account is a summary of our performance in the last year in relation to our quality priorities and national requirements. We have included information about other areas of quality to show how we focus on continually improving the safety, effectiveness and experience of the care and treatment we provide. 4 | Hounslow and Richmond Community Healthcare NHS Trust What is a Quality Account? A quality account is an annual report that providers of NHS healthcare services must publish to inform the public of the quality of the services they provide. This is so you know more about our commitment to provide you with the best quality healthcare services. It also encourages us to focus on and to be completely open about service quality and helps us develop ways to continually improve. Why has HRCH produced a Quality Account? HRCH is statutorily required to publish a Quality Account. This is the seventh year that we have done so; all of our Quality Accounts are published on our website: www.hrch.nhs.uk What does the HRCH Quality Account include? We collect a large amount of information on the quality of all our services within three areas defined by the Department of Health and Social Care: patient safety, clinical effectiveness and patient experience. We have used this information to look at how well we have performed over the past year (2018/19) and to identify where we could improve next year. We have defined three main priorities for improvement based on our Quality Strategy 2019 to 2023. About the Trust HRCH provides community health services for around 523,039 people registered with GPs in the London boroughs of Hounslow and Richmond, but also serves a wider population across South West London with a range of more specialist services. Every day our professionals provide high-quality healthcare in people’s homes and convenient local clinics. We help people to stay well in the community, manage their own health with the right support and avoid unnecessary trips to, or long stays in, hospital. During 2018/19 HRCH provided or sub-contracted more than 70 community, urgent care and primary care-based NHS services. We believe community health services are key to ensuring people receive the right care, in the right place, at the right time. We employ around 1,100 people, who work across a wide range of health centres, hospitals, GP surgeries, children’s centres, local council facilities and in community settings – including in people’s homes. A summary of the services we provide is outlined below and you can find out more about our community health services at: www.hrch.nhs.uk/our-services. Quality Account 2018/19 | 5 Services Adult services • Community Nursing and Night Nursing Service • Inpatient Unit • Urgent Care and Urgent Treatment Centres • Richmond Response and Reablement Team (RRRT), Hounslow Integrated Community Response Service (ICRS), Community Recovery Service (CRS) • MSK Physiotherapy, Podiatry, Dietetics, Speech and Language Therapy • Adult Specialist Nursing team including Intravenous (IV), Dementia and Parkinson’s Nurses Specialist services • Neurorehabilitation, Falls, Cardiac Rehabilitation, Heart Failure, Respiratory and Diabetes Services • Continence, Lymphoedema, Tissue Viability and Continuing Care Services • Wheelchairs and Postural Management • Learning Disability Children’s services • Child Development, Speech and Language Therapy, Physiotherapy and Occupational Therapy Services • Universal Children’s services – Audiology, Health Visiting, School Nursing, Family Nurse Partnership, Looked after Children’s Nurse, New Born Hearing Screening, Continuing Care Services for Children • Paediatric Community Nursing – Continuing Healthcare, Asthma, Bladder and Bowel, Haemoglobinopathy, Community Nursing Childhood immunisations • Richmond, Kingston, Sutton, Merton, Bromley, Bexley, Lambeth and Southwark Health and wellbeing • One You Hounslow • One You Merton • Help Yourself to Health Sutton 6 | Hounslow and Richmond Community Healthcare NHS Trust Overview and key achievements 627,171 343 patient appointments patients admitted to Teddington Memorial 523,039 Hospital inpatient ward population we serve 102,574 50,832 urgent care centre urgent treatment centre attendances at West attendances at Teddington Middlesex Hospital Memorial Hospital 248,890 9,582 the total number of district nursing and days patients were in community matron beds on the ward appointments 98% 1,100 97% of patients said they members of staff at March 2019 of patients said they were treated with felt they had been respect and in listened to dignified ways 21,965 people told us about 75,724 their care and treatment, compared to 14,363 in 2017-18 adult physiotherapy appointments 78,552 health visitor patients on average appointments 1,718 seen every day Quality Account 2018/19 | 7 Introduction from the chairman and chief executive Hounslow and Richmond Community Healthcare NHS Trust continues to play a vital role in improving the health and wellbeing of around 523,039 people registered with GPs in the boroughs of Hounslow and Richmond. As the Nursing Times’ best place to work for employee satisfaction, we continue to be impressed by our employees’ dedication, hard work and willingness to do things differently. Over the past 12 months they had 627,171 patient contacts here and across a wider range of locations in North West and South West London. Quality of care We were absolutely delighted when the Care Quality Commission awarded us a Good rating across all quality domains in October 2018, particularly as they highlighted six areas of outstanding practice: • The Hounslow Urgent Care Centre patient champion service works well to help homeless patients access services • The trust was the first to use the Wound Care Buddy app to determine the best way to treat patients’ wounds in their own homes • The wheelchair hub in Hounslow offers comprehensive wheelchair, seating and sleep systems for people with long term mobility problems • Intravenous therapy nurses developed a new way of administering intravenous antibiotics via portable pumps that patients wear around their necks or in their pockets when at home; this stops them having to go to hospital for treatment • The trust collaborates with a number of external providers; these relationships are positive and promote best practice • The children’s continuing care team delivers high quality care for children receiving end of life care; relatives told the CQC the team were a lifeline during periods of distress At the beginning of the year we welcomed our new medical director, Dr John Omany, FRCP, MBCHB, MSc, DipPallMed, DMRT who joined Donna Lamb, RN, RHV, MSc our Director of Nursing and Non-Medical Professionals, creating a strong clinical leadership team. We are a multi award winning trust, including two national awards in 2018/19: • Nursing Times Workforce Award for best place to work for employee satisfaction • Health Service Journal Workforce Award for our health visiting service redesign 8 | Hounslow and Richmond Community Healthcare NHS Trust Two of our nurses, Andrea Wilson and Teresa Keegal, were presented with Queen’s Nursing Awards and business support officer Jiwan Gumman won the South West London regional Skills for Health Award. Our two intravenous nurse specialists, Nicole Moodley and Jacqui Williams, were awarded second place in the Vascular Access Nurse of the Year category at the British Journal of Nursing Awards. In addition, we were shortlisted for two Flu Fighters Awards for innovation and creativity in our 2018-19 staff flu campaign and were shortlisted for another Nursing Times Award for the Wound Care Buddy App. NHS Long-Term Plan We developed a new strategy in 2018-19 in the context of existing NHS policy and indications of what would be included in the NHS Long Term Plan. It recognises the need to work much more closely with health and care partners (particularly primary and social care) and the voluntary sector. We continue to engage with staff, patients, their families, carers and the wider community on our plans to deliver co-ordinated services. We need to shape care around the needs of patients, not services, providing care that is seamless and easy to navigate. Alongside this, we refreshed our vision, mission and values. More information on this can be found on our website at www.hrch.nhs.uk. We are members of the North West London and the South West London Health and Care Partnerships, which are refreshing their plans, with renewed emphasis on the themes of ‘Start well, Live well, Age well’. At Borough level, we are taking a lead on community health services as part of the Hounslow and Richmond Health and Care provider alliances. We are also working in partnership with the Hounslow GP Federation and the Richmond GP Alliance to redesign services focused on co- ordinated care and improved patient outcomes. In the same week that the NHS Long Term Plan was published in January 2019, the Chief Executive Officer of NHS England, Simon Stevens, visited some of our urgent community response and recovery services in Richmond. He was interested to see how community healthcare services are already working in ways proposed in the Plan.
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